The expression of pain
There is a big difference in the expression of pain depending on whether it is acute pain or chronic pain.
Acute pain
Acute pain is often expressed as arousal, anger, and anxiety, which helps the body mobilize energy to avoid injury and ensure survival. An example of an acute pain response that most people may recognize is a situation where someone drops something very heavy on your foot. You will immediately pull your foot up, jump around on one leg and your face will be contorted in pain as you rub your foot and moan.
Chronic pain
The expression of chronic pain is often completely different. It can be hard to tell when someone is suffering from chronic pain. They don't moan, scream, or jump around making faces every day, which would be a normal reaction to acute pain. Instead, they might sit quietly, smiling and laughing like everyone else as they talk about the unbearable pain, they are in, perhaps even at this very moment. This is a common adaptation to the situation with chronic pain.
However, over time, if the pain worsens, the expression will often start to resemble depression. Since chronic pain has no purpose, it is often perceived as meaningless. Chronic pain sufferers can appear depressed, discouraged, passive, and withdrawn, which is understandable, but it is inconvenient and inhibits survival.
This adapting to the situation can often cause chronic pain sufferers problems when interacting with others, including family, friends, therapists, social workers, and so on. It can be hard for others to believe that someone can look and react like this (i.e. in a normal way) if they are in severe pain. Many patients have experienced suspiciousness, not being taken seriously, or even being accused by others as if it is just going on "inside their head". This is often due to the ignorance of others about chronic pain.
One should never doubt the pain experience described by others. Chronic pain is not the same as a long-term acute pain. It is a long-term and, for some, lifelong condition of painful suffering and disability.
